Coastal Optical, Incorporated

Primary specialty

OpticianTaxonomy code 156FX1800X

Legal business name

COASTAL OPTICAL, INCORPORATED

Practice address

401 79TH Ave N
Myrtle Beach, SC 29572-4310

Phone

(843) 449-6951

Fax

(843) 497-2960

NPI assigned

Jan 23, 2007

Last updated

May 4, 2009By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mrs. Carol L. Rateliff

Title

Office Manager

Phone

(843) 449-6951

Specialties & licenses 1

Addresses

Other identifiers 1

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1169510400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1241395200000",
    "number": "1689728016",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 79TH AVE N",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295724310",
            "telephone_number": "843-449-6951",
            "fax_number": "843-497-2960"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 79TH AVE N",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295724310",
            "telephone_number": "843-449-6951",
            "fax_number": "843-497-2960"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COASTAL OPTICAL, INCORPORATED",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-23",
        "last_updated": "2009-05-04",
        "status": "A",
        "authorized_official_last_name": "RATELIFF",
        "authorized_official_first_name": "CAROL",
        "authorized_official_middle_name": "L.",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "843-449-6951",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "156FX1800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Technician/Technologist, Optician",
            "state": "SC",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MC PIN NUMBER",
            "identifier": "0851690001",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Coastal Guardians LLC
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• Coastal Home Care (American HomePatient)
• Coastal Human Resources LLC (Comfort Keepers #265)
• Coastal Med Spa, LLC
• Coastal Periodontics LLC (Coastal Periodontics)
• Coastal Podiatry Associates PA
• Coastal Podiatry Associates PA
• Coastal Podiatry Associates, PA
• Coastal Recovery & Wellness, LLC (Coastal Recovery)

• Optician in Myrtle Beach, SC
• Providers in Myrtle Beach, SC by specialty
• Optician in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.